Effect of stratified management and stepwise training on pulmonary rehabilitation in older patients with liver cancer

Abstract

BACKGROUND

Older patients with liver cancer often experience impaired pulmonary function post-surgery, increasing complications and recovery challenges.

AIM

To investigate the effects of evidence-based stratified management and stepwise training in the perioperative pulmonary rehabilitation of older patients with liver cancer, providing a basis for clinical application.

METHODS

In total, 120 older patients with liver cancer who underwent surgery at our hospital between February 2023 and February 2025 were selected and randomly divided into study and control groups, with 60 patients in each group. All the patients underwent radical hepatectomy. Postoperatively, the control group received routine nursing management and rehabilitation training, while the study group received evidence-based stratified management combined with stepwise training for a continuous intervention period of one week. Time to first ambulation, length of hospital stays, and average hospitalization costs were recorded. Oxygen saturation (SPO₂) was measured on postoperative day 1 and day 3. The 6-minute walk distance and Borg scale scores were assessed on postoperative day 1 and day 7, respectively. The postoperative complication rates were recorded.

RESULTS

The study group had a significantly shorter time to first ambulation, shorter hospital stays, and lower average hospitalization costs than the control group (P < 0.05). On postoperative day 1, there was no significant difference in SPO₂ between the groups (P > 0.05); however, on postoperative day 3, the study group had significantly higher SPO₂ (P < 0.05). On postoperative day 7, the study group showed a significantly longer 6-minute walk distance and lower Borg scores than the control group (P < 0.05). The incidence of postoperative complications in the study group was 3.33%, which was significantly lower than that in the control group (13.33%; P < 0.05).

CONCLUSION

Implementing evidence-based stratified management combined with stepwise training in the perioperative pulmonary rehabilitation of older patients with liver cancer is improves lung function, reduces complications, and promotes effective recovery, demonstrating significant clinical value.

Keywords: Evidence-based stratified management; Stepwise training; Older patients; Liver cancer; Perioperative; Pulmonary rehabilitation

Core Tip: This study evaluated a novel rehabilitation strategy that combined evidence-based stratified management and stepwise training in older patients with liver cancer. The findings indicated that this approach enhanced postoperative recovery, improved pulmonary function, shortened hospital stay, and reduced complication rates, thereby supporting its clinical application in perioperative pulmonary rehabilitation.